【摘 要】
:
A (very) brief history of tension in nerve repair: Successful nerve repair is achieved by conveying as many axons successfully to their targets as possible. Typically, this is best achieved through a direct end-to-end repair under minimal tension (Millesi
【机 构】
:
Department of Neurosurgery,Massachusetts General Hospital/Harvard Medical School,Boston,MA,USA;Depar
论文部分内容阅读
A (very) brief history of tension in nerve repair: Successful nerve repair is achieved by conveying as many axons successfully to their targets as possible. Typically, this is best achieved through a direct end-to-end repair under minimal tension (Millesi, 1986). However, this is not feasible in most cases of trauma, where a segment of tissue damage must be excised and overcome. This has most commonly been addressed with the use of nerve grafts to bridge the gap. Autologous nerve grafts are considered the gold standard, with allograft or synthetic substitutes demonstrating some success over shorter distances. Despite their utility, autologous grafts pose challenges of their own. These include functional deficit in the donor distribution (typically sensory), extended operative duration, additional scarring, and a lack of intrinsic blood supply. They are also a poor anatomical match for the stumps being bridged, both internally (disparate neuronal size and composition) as well as externally (often requiring cabled bundles to approximate the caliber of the nerve being repaired). Finally, unlike end-to-end repairs, autologous grafts also require axons to traverse a second repair interface, where a large proportion of axons are lost across the anatomical discontinuity.
其他文献
Exercise and brain health: Physical activity helps promote and maintain our brain health, including memory and cognitive performance. Research has shown that exercise is a safe behavioral intervention that reduces the risk of hypokinetic diseases, such as
Among the risk factors for late onset sporadic Alzheimer\'s disease (AD) is the expression of ε4 allele of apolipoprotein E (APOE4) gene (Mahley et al., 2006). Elevated amyloid processing and reduced degradation of Aβ, which lead to Aβ plaque deposition
The devastating outbreak of the ongoing coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has affected not only the lives of almost everyone around the world but also the governments and societies as we
Axon regeneration requires protein synthesis and membrane expansion. The presence of granular material was discovered in the perikaryon of neurons but not axons using Nissl staining (Gomes, 2019). This is one of the characteristic features of neurons and
Regeneration of long axons after the spinal cord injury (SCI) will benefit patients with extensive traumatic damage to the white matter pathways who experience intolerable, permanent, neurologic deficits even after neuroprotective treatment with anti-infl
In many tissues, trace metals such as iron (Fe), zinc (Zn), and copper (Cu) are important for various physiological functions such as immune function, cell division, and enzyme function. However, it has been shown in humans and experimental animal models
Lysosomes are the major degradative compartments within eukaryotic cells. Besides their role in the degradation and recycling of intra- and extracellular molecules, they further mediate important biological processes, such as immune signaling and perpetua
One of the key challenges in neuroscience is that the central nervous system (CNS; the brain and spinal cord), is largely unable to regenerate after injury. One factor contributing to this lack of repair is the accumulation of cellular and myelin debris a
Worldwide, more than 40 million people are afflicted with Alzheimer\'s disease (AD) (Esquerda-Canals et al., 2017). AD is a devastating neurodegenerative disroder characterized by progressive decline in cognitive abilities. A hallmark of AD and other ne
Dystonia is a common movement disorder characterized by sustained or intermittent muscle contractions causing abnormal movements and/or postures (Keller Sarmiento and Mencacci, 2021). The dystonic syndromes are classified as primary dystonia (dystonia is